Abstract

The airway inflammation extends to the small airways in many asthmatic patients. For this purpose, the results of randomized treatments of patients with newly diagnosed asthma, were retrospectively evaluated to demonstrate that the usage of ultrafine particle inhalers are better for patients with small airway involvement.

Results of pulmonary function tests (PFT) and ACT (asthma control test) before and after 3 months of treatment for 45 newly diagnosed asthma patients on inhaler therapy started randomly according to GINA guidelines were reviewed retrospectively. 23 cases selected as small airway involvement according their 1-FEV3/FVC value of 10% or more. They were divided into 2 groups according to their usage of ultrafine particles (ciclesonide or beclomethasone + formoterol) (n= 15) or dry powder inhaler (budesonide or budesonide + formoterol) (n= 8). PFT and ACT's of groups at baseline and after 3 months were compared.

The average age of 23 patients with small airway involvement is 42.6. 15 of them are females (65.2%). FEV1 at 3 months of the cases with ultrafine particles were better improved compared with those used dry power inhalers (p=0.017). But ACT was not significantly changed between the groups (respectively, 22.79, 22.85) (p>0,05).

Beginning the inhaled therapy with ultrafine particles according to 1-FEV3/FVC value of 10% or more in patients with newly diagnosed asthma resulted in statistically significant improvement of FEV1 in short time period. We suggest that the small airway involvement must be investigated before giving inhaled therapy.